Awake Upper Face and Brow Lift

Conveniently located to serve the areas of Los Angeles and Beverly Hills
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An Awake Upper Facelift is a cosmetic facial rejuvenation surgery that mitigates the effects of aging in the brow and forehead without the use of general anesthesia. Instead, local anesthesia enables upper facelift patients to stay alert but comfortable throughout their procedure. Awake procedures are safer and feature a more comfortable recovery.
At first glance, a facelift without general anesthesia may seem unusual. But every year, more and more surgeons are realizing the clear post-surgery benefits Awake procedures can provide for patients. Local anesthesia can actually reduce long-term discomfort and shorten post-surgical recovery time. Every year, more and more people are choosing Awake cosmetic procedures to make their aesthetic aspirations a reality.

If you wish to improve signs of aging surgically, but don’t want to deal with the side-effects of general anesthesia, an Awake procedure may be the answer. Dream Medical Group Plastic and Reconstructive Surgery provides aesthetic surgical services to patients from Los Angeles and farther afield. Board-certified plastic and reconstructive surgeon Dr. Kenneth Kim specializes in Asian plastic surgery, and has extensive experience with Awake procedures. Call us today at 213-700-4297, or fill out an online inquiry form to book a consultation with Dr. Kim and discuss your facial rejuvenation goals.

About the Aging Process

Facelifts are sophisticated plastic surgery procedures that alter facial soft tissues to achieve a more youthful appearance. (1) Over the years, our skin loses its youthful elasticity and adaptability, and our facial soft tissues experience structural changes that affect our appearance. Rhytides – commonly known as wrinkles and lines in the skin – can become more apparent on the surface of our skin as we age. They can appear in a number of conspicuous places.

The Brow

Sagging in the brow can make us appear less alert, tired, or even like we are constantly in a bad mood. It can be a result of aging, nerve injury, or neuromuscular disorders. (2) Problems such as skin sagging do not resolve without intervention and only worsen over time, becoming more prominent as time goes on. Moreover, we may find that the skin in our entire upper face has lost its youthful vigor and vibrancy.  

The Forehead

As time progresses, horizontal lines in the forehead become more pronounced when we raise our eyebrows, and glabellar lines, the rhytides between our brows, can appear when we frown. We may feel as though any minor facial muscle movement causes a wrinkle or a crease to appear, which can make us self-conscious about our appearance.

The Eyes

Our eyes are our biggest non-verbal communicators. As we age, the tissues around them can change significantly. A sagging brow can make us look sleepy or angry when we may not be, and a common complaint from patients who request an upper facelift is their “droopy eyes”. (2)

An upper facelift procedure can
  • Restore youthful contour to the brow, forehead, and eye area
  • Lift and smooth horizontal lines and glabellar lines
  • Provide long-term surgical anti-aging results
  • Soften the appearance of skin
  • Tighten sagging skin in the upper face
  • Provide a “more alert” refreshed aesthetic
An Awake upper facelift can effectively address aesthetic concerns in the upper face and forehead. Of course, there are other facelift options and eyelid services available to meet individual needs. The type of facelift required depends on the number of areas of your face you wish to improve, which can be discussed at length during your personal consultation.

General Anesthesia Risks

Anesthesia enables doctors to control a patient’s awareness of pain during a surgical procedure. It is a precise art that has been widely used, and as some would argue, over-used. There are a number of risk factors associated with general anesthesia that all patients should understand before their treatment date. Unlike local anesthesia, the effects of general anesthesia can destroy neurons in the brain, particularly the brain cells associated with memory.(2) Additionally, general anesthesia procedures come with the added risk of complications such as

  • Blood Clots
  • Deoxygenation
  • Heart Attack
  • Ventilator Failure
  • Dangerously High Body Temperature
Post-surgery, general anesthesia may cause
  • Severe nausea
  • Sore throat from intubation
  • Muscle Aches
  • Extreme cold/shivering
  • Extreme fatigue
  • Motor function impairment

With general anesthesia, the brain’s pain response is altered for longer than just the duration of the surgery. At the time of surgery, pain receptors are “asleep” but, remarkably, the brain is still aware of what is happening. Tests indicate that neurons in the brain produce a cascade of increased electrical activity, even though the patient is not conscious. This increase in neuron activity can result in nerve hypersensitivity. This results in patients experiencing residual pain that may last for a longer period of time after their surgery is completed.

Benefits of an Awake Upper Facelift Procedure

Awake anesthesia has a much faster and undemanding recovery period compared to general anesthesia. Though patients should still expect some discomfort after their Awake surgery, the duration is much shorter and much easier to manage. Whereas general anesthesia may require pain medication for up to two weeks after their surgery, Awake anesthesia may only require a few days of the same medication. An upper facelift procedure

  • Avoids long-term nerve sensitivity after surgery
  • Reduces the prolonged need for pain medication
  • Limits nausea, fatigue, and throat pain 
  • No loss of consciousness in the patient
  • The doctor performing the surgery has real-time ability to interact with his Awake patient during the procedure
  • Allows for smaller budgets when considering plastic surgery options
  • More convenience after surgery

Procedures with Awake anesthesia require expert anatomical knowledge. A dilute local anesthetic is strategically injected to target both deep and superficial nerves to provide the highest level of comfort during the procedure. Afterwards, you will see its benefits as you recover quickly, with minimal discomfort.

Speak with Awake anesthesia expert Dr. Kim at a personal consultation to discuss the ways an Awake upper facelift could benefit you. Fill out an inquiry form online to arrange your appointment, or call us at 213-700-4297 to speak to our scheduling staff directly.


Men and women who desire a more youthful appearance in their upper face and who want to avoid the risks and side-effects of general anesthesia may be good candidates for an Awake upper facelift. Moreover, if you are looking for more than just a brow lift, and wish to address signs of aging in your forehead, Dr. Kim can easily incorporate this into your treatment. Generally, candidates should be in good overall health with no chronic conditions that could affect the success of their surgery. 

Personal Consultation

beautiful woman touching her face stock imageUsing his extensive knowledge of facial anatomy, Dr. Kim individualizes each treatment plan to help his patients reach their aesthetic goals. Prior to surgery, you will meet with him at a one-on-one appointment to discuss your desired results. He will carefully examine your face, noting skin ptosis and rhytide severity. He will also provide specific details about the cosmetic procedure he judges to be most beneficial for your unique circumstances. Younger patients with minimal signs of aging may be best served by an endoscopic approach. Older patients with more extensive laxity and wrinkling will require a coronal lift, which removes excess skin and treats the entire surface of the forehead. Dr. Kim will recommend the best approach for your case and explain the benefits of an Awake procedure in greater detail. 

Preparing for Your Forehead Lift

Preparation for an Awake upper facelift is as follows.
  • Stop taking aspirin, NSAIDs, certain herbal supplements, and other blood-thinning medications two weeks before your surgery.
  • Stop smoking in the weeks before and after your treatment, as nicotine impedes the healing process.
  • Avoid UV exposure and use high SPF sunscreen when you cannot avoid the sun.
  • Arrange for someone to pick you up from our office after surgery.

Awake Upper Face and Brow Lift Procedure

Before your surgery takes place, we will prepare your face by marking the targeted areas. After carefully and strategically injecting local anesthetic, Dr. Kim will wait until the area is fully numbed and that you are comfortable before beginning the procedure. At your request, Dr. Kim can provide additional oral sedation for your comfort. Dr. Kim performs lifts to the upper face using two surgical techniques.

Endoscopic Brow Lift

This minimally invasive approach uses only small points of entry, one of which accommodates an endoscopic camera, which allows Dr. Kim to operate underneath the skin. He will adjust the underlying tissues as necessary, and introduce endotine devices for effective lifting. These small biocompatible devices are used to lift and anchor the tissues of the forehead in a higher position under the skin. This provides an effective lift to the sides of the forehead and brow.

Coronal Brow and Forehead Lift

For patients requiring more comprehensive lifting, Dr. Kim will perform a coronal lift. Several incisions are made above the hairline to allow access to the underlying tissue. 

These tissues will be adjusted as necessary, and he may modify the muscles to provide a smoother forehead. He will remove excess skin where necessary, and the incisions are sutured closed. Any scarring will be well-hidden in the hairline. Typically, a brow lift surgery takes between one and two hours, however, with additional forehead alterations, the procedure may be longer.

Recovery and Results

Follow the post-surgical directions provided by Dr. Kim. During your recovery, expect to see some temporary bruising, swelling, and tightness. In the initial stages of your recovery, you may experience some numbness, which will usually resolve following your treatment. Dr. Kim can prescribe pain medication where necessary, though more than a few days’ worth of oral medication is usually not required for Awake procedures. 

In the coming weeks, the swelling will reduce significantly, and you will see the long-lasting, lifting, wrinkle-smoothing effects of your upper facelift.

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Cost of an Awake Upper Facelift (with Forehead) in Los Angeles

The pricing system for plastic surgery procedures at Dream Medical Group is based on the individual goals of each patient, and the surgical complexity of the procedure. Therefore, the cost of an Awake upper facelift will vary according to specific patient circumstances. Patients may find an Awake procedure to be significantly more cost-effective than treatment under general anesthesia. For more information about Asian Plastic SurgeryDynamic Surgical Techniques, and information to help patients Prepare for Surgery, please browse our website. You can also find out about the latest surgical techniques and popular cosmetic treatments on our blog.


  1. Yang, A. J., & Hohman, M. H. (2021). Rhytidectomy. PubMed; StatPearls Publishing. 
  2. Dunn, T., & Hohman, M. H. (2021). Pretrichial Brow Lift. PubMed; StatPearls Publishing. 
  3. Sall, J. W. (2016). Anesthesia Kills Brain Cells, but What Does It Mean? Anesthesiology, 125(6), 1090–1091. 
*Results May Vary